Head, Division of Neurosurgery, UBC/VGH; Assistant Professor, UBC, Department Surgery; Director, BrainCare BC, BC Cancer Agency

There is a lot of information available about current treatment strategies for brain cancers, but I’d like to touch on just a few points here.

First of all, until about five years ago, the outcomes for brain cancer were stagnant for decades and there was very little progress. At that time a new drug, called Temozolamide, was used in combination with surgery and radiation which resulted in an improvement in two-year survival. Without the drug, the chances of survival were one in 10 and now with the drug, the chances are one in four—a pretty good improvement, I would say.

Secondly, there is the notion of conventional versus experimental or investigational treatment options. I know there is a sense that the latter will lead to conventional outcomes; and there is also a notion that experimental or investigational treatments will give you the chance of a miraculous outcome.

Well, the truth is that what are now labelled conventional treatments were once the same sexy and alluring experimental/investigational treatments of six years ago. It’s just that they actually turned out to be useful and as a result, graduated from experimental to conventional. It’s really like graduating from boyfriend to husband. Although boring, yes, it becomes stable and reliable (no comments necessary).

There is a reason why a drug or treatment is termed experimental. It’s because we aren’t yet sure it will work—in fact we are not yet sure that it will not be harmful. All of these drug studies have their time and place though. In general, it’s good to start with what has a proven track record of success and have the remaining experimental treatment options in mind only if the need arises (but the same does not apply to the boyfriend example).

Brian